Health Care Reform: Share Your Thoughts March 17, 2010
Posted by Heart Rhythm Society in Health Policy, Scientific Sessions.Tags: Quality & outcomes
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The Heart Rhythm 2010 Opening Plenary session, taking place on Wednesday May 12 at 4:15 p.m., will officially kick-off the Heart Rhythm Society’s 31st Annual Scientific Sessions. As you may know, this year the plenary will focus on health care reform, the shift toward outcomes-based payment system and its impact on the practice of medicine. The panelists will address several tough questions including:
- What is the impact of these changes on patients’ access to heart rhythm disorder care?
- What is the impact on your practice as Medicare and Private payers are moving from fee-for-service to quality outcomes-based payment system?
- How do we redefine the financial relationships with industry?
- What is the impact on professional medical education?
The Heart Rhythm Society has been actively involved in health care reform discussions over the last year, and has expressed our concerns to lawmakers several times. To learn more about the Society’s concerns, please visit http://hrs.informz.net/survistapro/s.asp?id=3861.
As we are preparing for this session, we would like to hear your questions or concerns.
Please tell us what you think in the comments section about health care reform and its future impact on our practice.
Richard I. Fogel, MD, FHRS
Chair, Health Policy Committee
Heart Rhythm Society
Laurie Racenet, RN, MSN, ANP
Michael Giudici, MD, FACC, FACP, FHRS
Heather M. Ross, DNP, ANP-BC, CCDS, CEPS, FHRS
Anne Dubin, MD, FHRS
John D. Day, MD, FHRS
Andrea M. Russo, MD, FACC, FHRS
Joshua M. Cooper, MD, FACC
Amit J. Shanker, MD, FHRS, FACC
Bruce Stambler, MD
David Wiggins, RN, BS BME, CEPS
Fred M. Kusumoto, MD, FHRS
Leonard Ganz, MD, FHRS
christinechiuman
Craig Delaughter, MD, PhD
Ariana Del Negro, Heart Rhythm 2010 Quality
Peng-Sheng Chen, MD, FHRS
MSKremers MD,FHRS
Ann C. Garlitski, MD, FACC, FHRS
Alan Cheng, MD, FHRS
Ulrika Birgersdotter-Green, MD
Christopher Clyne, MD, FHRS
Kathleen Blake, MD, MPH, FHRS
David Scher, MD, FHRS
Sanjay Deshpande, MD, FHRS
Thomas F. Deering, MD, FHRS
Please find ways to address the increasing trend of practice consolidation and purchase by hospitals of those practices and the degree to which this will improve or worsen issues of access to care and the effect on patients and payers on the price they pay for care.
A “positive outcome” is a moving target in medicine, and certainly that can be the case in our subspecialty. Consider AFIB ablation: a positive outcome could range from complete elimination of arrhythmia, to increased efficacy of a drug, to marked reduction of symptoms while your patient is still in fact in AFIB! So how can we apply outcomes criteria in a meaningful and egalitarian fashion for conditions to which our patients can have such variable clinical responses?
Why in all the discussion is there only passing mention of tort reform. The “unseen” cost of defensive medicine is significant. Could it be the sums of money contributed by trial lawyers and the fact that those writing reform happen to be lawyers? We as a profession need to be more vocal and cohesive on this issue.
Also physician-industry relations are important to progress in patient care. We should not “run scared” from this issue. Clearly abuses and gross conflict must be eliminated. However, we and industry should not be vilified for trying to push advances in patient care technology.
[Editor's note: Below is a comment from the Society's LinkedIn group made in response to Dr. Fogel's post. As that group is for members only, the name of the author has been removed.]
“At least in part, our current financial mess is related to unrestricted ordering/repetition of unnecessary tests by some practicing cardiologists and electrophysiologists, and this needs to acknowledged and addressed. Obtaining repeat ‘surveillance’ echocardiograms every 6 months, obtaining $20,000 worth of testing (including cardiac catheterization!) for what is clearly vasovagal syncope, ordering long-term outpatient MCOT monitoring without indication, repeating DFT/DSM testing annually, etc. are just some of the egregious examples of waste that come to mind. It is small wonder that insurance companies want to ‘police’ our utilization of tests! As an academic electrophysiologist, I see such waste often, and it is clear that there are some repeat offenders.”
[Editor's note: Below is a comment from the Society's LinkedIn group made in response to the preceding comment on Dr. Fogel's post. As that group is for members only, the name of the author has been removed.]
“I agree with the spirit of [this] comment. However, much of what we do (at least noninvasively in my practice) is driven by defensive medicine. That is a big issue not addressed in the wonderful landmark health care reform law.”
The impact of Health Care Reform, in combination with the 21% reduction of Medicare reimbursement may spell the death nell of many cardiovascular practices. What would Mr Daschle suggest that patients dependent on their Cardiologist or Electrophysiologist when their practice closes or curtails their Medicare patient seeing days do for their acute and chronic cardiovascular problems when there are no longer enough Cardiologists and Electrophysiologists to see them when they are sick?